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4668 Ridge Cliffe Dr - BL88917 For Office Use I Z~ t7 U - rf i u Permit non City of Ea < Permit Fee: APR 2 3830 Pilot Knob Road Eagan MN 55122 Date Received: I Phone: (651) 675-5675 I Fax: (651) 675-5694 1 Staff: 2008 RESIDENTIAL BUILDING PERMIT APPLICATION c, 8 R,d go C'l r- -P_ D v_ Date: Site Address: Tenant: Suite RESIDENT / OWNER Name: (3 T9 Q U C l Phone: LS I I L_ .-7 V U Address / City / Zip: lp L 8 f (I q t t t Applicant is: Owner Contractor TYPE OF WORK Description of work: 3 wtiid aw 1' tp [o lym/ A-7s fn I ?(J 7~f)7 o,2r/)/f f ) Construction Cost: 3 aOt l.~ Multi-Family Building: (Yes No THD At-Home Services, Inc. CONTRACTOR Name 2690 Cumberland Pkwy, Ste 300 License Addre Cumberland Office Park ( l 3 y S- t b Y 7 Atlanta, GA 30339-3913 City: - Lic# 20268257 Ph. 763/ 542-8826 - State: Zip: Phone: Contact Person: ~ Elder JbntS COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING Minnesota Rules 7670 Category 1 Minnesota Rules 7672 Energy Code • Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet Category Submitted Submitted submission type) • Energy Envelope Calculations Submitted In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan? _Yes No If yes, date and address of master plan: Licensed Plumber: Phone: Mechanical Contractor: Phone: Sewer & Water Contractor: Phone: NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of the information may be classified as non-public if you provide specific reasons that would permit the City to conclude that they are trade secrets. I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. plicant's Printed Name (Applicant's Signature Pagel of3